RT Journal Article SR Electronic T1 Epidemiology of Staphylococcus aureus in Neonates on Admission to a Chinese Neonatal Intensive Care Unit JF bioRxiv FD Cold Spring Harbor Laboratory SP 529941 DO 10.1101/529941 A1 Wenjing Geng A1 Yujie Qi A1 Wenting Li A1 Thomas H. McConvillle A1 Alexandra Hill-Ricciuti A1 Emily Grohs A1 Lisa Saiman A1 Anne-Catrin Uhlemann YR 2019 UL http://biorxiv.org/content/early/2019/01/24/529941.abstract AB Purpose Little is known about the molecular epidemiology of Staphylococcus aureus in Chinese neonatal intensive care units (NICUs). We describe the molecular epidemiology of S. aureus isolated from neonates on admission to Beijing Children’s Hospital.Methods From May 2015-March 2016, nasal swabs were obtained on admission from 536 neonates. Cultures were also obtained from body sites with suspected infections. S. aureus isolates were characterized by staphylococcal chromosomal cassette (SCCmec) type, staphylococcal protein A (spa) type, multilocus sequence type (MLST), sasX gene, antimicrobial susceptibility and cytotoxicity. Logistic regression assessed risk factors for colonization.Results Overall, 92 (18%) infants were colonized with S. aureus and 23 (4%) were diagnosed with culture-positive S. aureus infection. Of the colonized infants, 72% harbored MSSA, while 74% of infected infants were culture-positive for MRSA. Risk factors for colonization included female sex, age 7-28 days, birthweight and vaginal delivery. The most common MRSA and MSSA clones were community-associated ST59-SCCmecIVa-t437 (60%) and ST188-t189 (15%), respectively. The sasX gene was not detected. Some MSSA isolates (16%) were penicillin-susceptible and some MRSA isolates (18%) were oxacillin-susceptible. MRSA and MSSA had similar cytotoxicity, but colonizing strains were less cytotoxic than strains associated with infections.Conclusions S. aureus colonization was common in infants admitted to our NICU and two community-associated clones predominated. Several non-modifiable risk factors for S. aureus colonization were identified. These results suggest that screening infants for S. aureus upon admission and targeting decolonization of high-risk infants and/or those colonized with high-risk clones could be useful to prevent transmission.